Change in compensated patient injuries in the treatment of Achilles tendon rupture: a nationwide analysis from 2000 to 2019.

Background and purpose:  Over the last 2 decades, the treatment of Achilles tendon rupture (ATR) has shifted from surgery to non-surgical methods. We aimed to analyze whether this change in treatment methods has had an impact on the number of compensated patient injuries in Finland and the grounds for compensation. We also aimed to investigate where injuries occur along the treatment pathway.

Methods:  We conducted a retrospective analysis of the Finnish Patient Insurance Centre's insurance charts of compensated patient injuries in the treatment of ATR. Records of all compensated patient injury claims involving ATR from 2 periods in Finland: 2000-2006 (when 65% were treated surgically) and 2013-2019 (when 15% were treated surgically) were reviewed. Data included medical records, expert evaluations, and compensation decisions. Injuries were classified by when they occurred, and key contributing incidents were identified.

Results:  From 2000-2006 (period 1) and 2013-2019 (period 2), there were 315 patient injury claims related to ATR treatment in Finland. Of these, 126 (40%) were compensated. In both periods, delay in diagnosis was the most common reason for compensation. The number of claims remained the same between the 2 periods, and the ratio of compensated injuries to total cases declined (0.70% to 0.62%, not significant). Between the periods, infection-related claims decreased, while those related to incorrect treatment pathways and surgical errors increased (P = 0.02).

Conclusion:  The number of patient injuries has not risen in the past decade, while the number of infection injuries has decreased. Most patient injuries were related to a delay in diagnosis.